PAINTMIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Bui ding Inspection Request
Dat -
Zvc(,
Type Insp'n
Permit No. s q- o.
Name iC Q
Address .(� N� q q
Company D(.
Phone #
Inspection Date
Approved
Correction
Re- Insp'n Fee
BUILDING
PERMIT APPLICATIO
FBC 2001
Permit Type (circle):
Owner's Name (Fee Simple Titleholder) Ch r' S r1q Phone # ,3c5 793 S7 c 0
Owner's Address 121' NE 1
City M tAtli 51ndreS State I~ L Zip '3313
3
Tenant/Lessee Name Phone #
Job Address (where the work is being done) SRS- ao Q BOVC
City Miami Shores Village County Miami -Dade
Is Building Historically Designated YES NO /
Contractor's Company Name
Contractor's Address
Miami Shores Village
Building De • artment
N � /Y
City State Zip
Qualifier
State Certificate or Registration No. Certificate of Competency No.
Architect/Engineer's Name (if applicable) Phone #
$ Value of Work For this Permit ? 114'3 0 03 Square Footage Of Work:
Type of Work: ❑Addition ® Alteration rr__ ❑New ❑ Repair/Replace ❑ Demolition
Describe Work: Pa ■n gxA Dior Ylot.ta
****************************F
Submittal Submittal Fe'e\$ 500 -` Permit Fee $ (O. O V CCF $ 2 . cid CO /CC
Notary $ 5.0 Training/Education Fee $ ' $O Technology Fee $ 1.5 U .
Scanning $ Radon $ Zoning — Bond $
Code Enforcement $ Structural Plan Review. $
Total Fee Now Due $
(Continued on opposite side)
res, Florida 33138
5) 756.8972
Master Permit No.
Electrical Plumbing Mechanical Roofing
Phone #
Permit No. 1 5 gad- )2
Zip
Bonding Company's Name (if applicable)
Bonding Company's Address
City State Zip
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City State Zip
Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has
commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating
construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS,
WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all
applicable laws regulating construction and zoning.
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING,
CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT."
Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
• for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be app p ayed and a reinspection fee will be charged.
Signatur
Owner or Agent Contractor
The fore instrument was acknowledge before me this cO ^ The foregoing instrument was acknowledged before me this
day of '; , 20 , by elim I wl 12r C,'1 day of , 20 _, by
who is personally k to me or who has produced "/ C who is personally known to me or who has produced
Sign:
Print:
* * * * * * * **
NOTARY
My Commis .• ion Expires:
* * * * * * * * * * * * * * * * * * * **
APPLICATION APPROVED BY:
Chc 05/13/03
AJLI
As identification and who did take an oath.
*********************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
as: identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
* / **************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
/(107
Signature
My Commission Expires:
•************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
Plans Examiner
Engineer
Zoning
APPLICATION APPROVED BY:
Miami Shores Village
Paint Color Approval and Agreement
Date
Owner's Name Chip/.f -///7 q l Phone# 3oC 73,c7-00
Owner's Address 1)s c/9 Si'
City
Signature
Owner or Agent
ae
State Zip
Job Address (where the work is being done)
City Miami Shores Village County Miami- ade Zip
si
Is Building Historically Designated YES NO
Contractor's Company Name (if applicable) Phone # , . _ .
***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
All elements on the site must be listed and indicate the
Wails . Cu5 ()ICI /11 c 19 e --,.
Fascia
Drip Cap /drip Edge
Soffit � �Q LJh t e I
Roof 22 �"
Flower bins
Shutters
Awnings c ((
Chimney / Doors and door jams ( /�
Garage doors /44l ("
Railings
Fences i. (
Decorative metal
All brick (simulated or regular)
Stucco banding
Any other stucco features I,,
Accessory Buildings l t ((a'' Crane (AA 1 k
Other
********************************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
P &ZOffi cia
!
516 -3 Bone White
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all wum r.
applicable laws regulating construction and zoning.
Date
•
/DI
Date /7/5
COLOR EW 2092
chc 6 /18/03
* **
: ith all
t(i ,
3F0Ve uck, yo3
7)1.5u ss Giowo CO/ e\
sic -fvc \ y CD■,10 -�
,k,r0t/W- &71- 4`:1/114
cu e
C2otitA4-0 \xuti
10050 N.E. SECS
11 SHORES, FLO -
Telephone: (305)'
Fax: (305) 75
kGENDA
ND ZONING
.nary 26, 2004
:00 P.M.
y 22, 2004
fiber 18, 2003
IESS 1
dilla (owners)
Inc. (owner) S
a
LL • 9 - 9
3aans NONVNNIn
E - 6L 3
)I311:18 3808V
Z 3
N3HM 311111
Z
3>IONS Aaana
1 3
See 50410(1)(g)(2): Sign
Miami Shores Village
Paint Color Approval and Agreement
Date 9' l 7.270
Owner's Nam e CLI1 S4"/ , �1 CC/ Phone
cif � ��
Owner's Address �� N C. t-1
City M ` " et,"'eQ S State Zip 3 3
30S- 753 S
Job Address (where the work is being done)
City Miami Shores Village County Miami -Dade Zip
Is Building Historically Designated YES NO . >`
applicable) Phone #
Contractor's Company Name (if a p � ) £;
************************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** * * ** * * * * * * * * * * * * * * * * * * * * * * * * * * * **
All elements on the site must be listed and indicate . e c 1 be ainted
Walls a4,,, /k e C , rtb 77 g%i)
acetvt-I
Drip Cap /drip Edge 11 'Z , N
Soffit � 7D) r �I
Roof ISOV kl Q
Flower bins N ( A
Fascia
Shutters 2. A -
Awnings a .-' o
Chimney 11 76,1) W A S 1 " "
u
Doors and door jams C A
Garage doors Ni 1_ A
Railings i1( A
Fences A ( A-
Decorative metal pi l ••''
All brick (simulated or regular) r o
Stucco banding M Pi t ( t� * L
J
Any other stucco features N O
Accessory Buildings 11 V5 N
. applicable laws regulating co
Signature
APPLICATION APPROVED BY:
Owner or Agent
P& Z Official
Attach Color Samples
With Numbers
Date
Date
t.
chc 6/18/03
Other — T - Lt.) dref i-
******************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * ** * ** ** * * ** * *u �� * * * * **
11 e,Sis}e, me..— Jev- ( b1d�e 1 •
OWNER'S AFFIDAVIT: I ce = yregoing information is accurate and that all be done e compliance ' with all
1,� �J 9/?°/ ° /
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204
Printed: 11/9/2004
Applicant: CHRISTINA
Owner: RICCI
JOB ADDRESS: 128
Contractor
Local Phone:
Parcel # 1132060132270
NE 99
Fees:
FEE2004 -11037
FEE2004 -11038
FEE2004 -11039
FEE2004 -11040
FEE2004 -11041
Description
Building Painting Fee
CCF
Notary Fee
Training and Education Fee
Technology Fee
Total Fees:
Amount
$60.00
$2.40
$5.00
$0.80
$1.50
$69.70
Total Fees: $69.70
Total Receipts: $69.70
Permit Status: APPROVED Permit Expiration: 3/22/2005 Construction Value: $1,600.00
Work: PAINT
Signed: (INSPECTOR)
In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict
conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responisibility for all work
done by either myself, my agent, servants or employes.
Signed: (Contractor or Builder)
Building Permit
Permit Number: BP2004 -1277
RICCI
CHRISTINA
ST
Contractor's Address:
BY:
Page 1 of 1
Legal Description: MIAMI SHORES SEC 1 AMD PB 10 -70 LOT 11 & E1/2 OF LOT 12 & W25FT OF LOT
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date 1/-36 9( Job Address /018 S Tax Folio / / - 3( 2 0 Jb - 0/3 2'' 6
.— �.= % Y / �`
Legal Description ,� D % �� - 0 h j� /7��Histoncall e� ed: es ce- No It
Owner/Lessee / Tenant / aa e A y Master Permit # 3 / al- 0
Owner's Address /2 / VE 9 / 'v
Contracting Co. 4/0 /Y�
Qualifier Nil( A V • (. 4,42/ SS# '( hone �l�' �1i�?�
State # Municipal # Competency # T °«
Architect/Engineer Address
Bonding Company Address
Mortgagor YO Me' Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL RO ING AP VING FENCE SIGN
WORK DESCRIPTION � SS ql e/ e/ .7Y /l /477
Phone ) r- 6
Address /V 0 A/ Az_
Square Ft. la 6 Estimated Cost (value) '3O D
- ,
WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING,
CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.)
Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I
certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate
permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK.
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable
laws regulating construction and zoning. Furthermore, I authorize the above -name ontract.j o do the work stated.
Notary as to Owner and/or Condo President Date
My Commission Expires:
Signature of C
- Builder
Notary as to Contractor or Owne -Bui
My Commission Expires:
q
Date
ll
//n
Date
FEES: PERMIT, RADON C.C.F. _ S NOTARY sc TOTAL DUE L Ks'
APPROVED: 1 �j
Buildin + / Electrical
Zoning g � g�
Mechanical Plumbing Engineering .
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